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Hello, everyone. My name is C now I'm the um junior doctor Education Officer for uh Ir Juniors. Welcome to our applying to radiology webinar series. Today is our third and final talk um on a FP application. I know it's um quite late for the application since the A FP um closes tomorrow at 4 p.m. But if there's anyone who's interested in applying for next year or interested in a last minute application, um I urge you to listen in. So we have Doctor Vasilis here with us today um who is very, very qualified um having given his linkedin a bit of a stoke. He has graduated from medicine in Athens, then came over and did a masters at Imperial in Molecular Medicine. Then he completed his foundation training in the Isle of wight and Oxford did a neurosurgery ST one in Oxford as well and then completed his course of surgical trainee um years in London before starting a Masters in Statistics and a phd in prostate MRI at UCL. He's currently an ST one academic ST one at Imperial working on um vascular and cardiac MRI Imperial. So welcome to see this and um please take me over the stage. Thank you so much. Uh Thank you for having me. Thank you for introducing me. Uh I think the direction was a little bit too generous. Uh But uh I'll try to give everyone a little bit of a rundown for the academic foundation program applications as they applied to radiology. Um I'd like to start off by saying um that it is a little bit intimidating in that the application is a little bit separate to uh the standard clinical applications, but I'll take you through the process and hopefully by the end of this, uh it won't sound so intimidating and I would encourage anybody to apply even if it's last minute, if they really want to do it. Uh There's actually a few hours left before the deadline, so it's doable. So uh I think uh most of people on the call would actually know a little bit about the ACF uh what is an ACF uh essentially it's an NIH R funded uh integrated clinical academic pathway. So what does this mean? It means that the NIH R which is a National Institute of Health Care Research is actually providing uh local aca especially big academic centers with some funding. And that funding is essentially used to buy out a little bit of your of a trainee salary to ensure that they have protected time for research. So usually what happens is that very commonly the academic foundation uh uh sorry, the academic uh clinical fellowships, they consist of a three or three year posts where you do 75% clinical uh training and 25% research. The way that you do the 25% research is essentially up to you and the demands of the program that you're training in. So for example, if um I wanted to do one day a week or one week a month or three months in a year, that's entirely up to me provided, there are no on call or clinic commitments or award commitments that uh are making this particularly difficult. So you will find, for example, that uh in heavy surgical specialties, you might uh uh this might be giving you uh as it is and you don't have a choice as to how you're gonna spend your 25% research over three years, you might actually get a six month or nine month block in year two or year three in radiology. I think it's a little bit more feasible uh to split the time. However, you want, however, obviously, you have to discuss it with your uh clinical academic supervisors to make it happen. Uh Just to give you one example, I actually haven't embarked on my 25% research yet, although I got in the program last year because uh the first few months of radiology are considered an induction period. So therefore, all trainees have to get through it before we even discuss how we're going to spend the 25% research time. Why do people, why do AFS exist? Uh That's a very long and convoluted. Uh uh There's a long, long eed answer to that question. But the original idea is that you produce pilot data and you spend uh some a few months scrutinizing literature to actually generate some ideas for A phd. And once you generate those ideas and produce some preliminary data, then you can take your ideas to a founder such as the Medical Research Council uh or NIH R or any other big founder to then apply for a clinical research training fellowship which will fund your phd degree. So obviously, the inflation we've seen in the last few years in terms of the publication records and the job requirements and the qualifications of people coming in means that that original idea is kind of getting lost a little bit. So now you have some people like myself who already have a phd that are getting accepted into ACF S. Um I think that's not necessarily the best way of doing things, however, that's how things are moving, unfortunately. Um And it's very often the case that some people who are already quite uh research oriented and qualified actually get into the ACF But if you ask me for my personal opinion, it actually, it should actually be the other way around. It should be for people who have potential, but they have not actually an opportunity to go into a big academic center and work on uh a, a fascinating research project. Um That's something to be aware of, but I still wouldn't be discouraged uh by the process. Um And just generally, if you really wanna go for it, I would advise you to really go for it. The ACF has uh apart from a protected time, it has a few added extra benefits in that it gives you um there's some funding on the side and that funding can be used for consumables. It can be used for conferences. Uh It can be used for courses which actually you're obliged to do some uh MSC level modules. So if I wanted to um really make the most of my si would really have to take some extra modules on teaching or management or um let's say advanced data analysis or statistics, things that generally are not clinical medicine and that's part of a requirement of your ACF you have to uh do other things apart from a clinical. And it goes without saying that in a 75% clinical time, you have to achieve 100% of your competencies. So, although you do have 25% predicted research, the reality is that often, what happens is that you really have to push in your clinical days uh to achieve the competencies. And it also means that you uh also might have to um erode a little bit of research time to every now and then to basically meet your clinical company. So that's the reality of the situation, the ACF S uh typically last three years. And then after that, you transition to your standard clinical training. So in my in radiologist case, you got an ACF at uh ST one, you do the DST three. And then at the end of that, you transition to ST four with everybody else in, in your cohort, hopefully with a few good publications and preliminary data for A phd and under your belt. What is not an E CF? Um And this is why I will say time and time again throughout this lecture, do not be discouraged um from applying, you know, do you do not see N AF application, your sole opportunity to become a clinical academic if that's what you really want? Um And I'll explain later on why uh any applying for an ACF is not an excuse to neglect clinical applications. You have to absolutely focus on both if you want my personal advice because ACF S are much more competitive with the clinical applications. A clinic, clinical application are uh essentially the core, it should be your core focus. Because if you succeed in a clinical post, there's lots and lots and lots of things you can do to do research afterwards. You don't need necessarily an ACF to succeed in research if you go to clinical post. So your clinical uh post has to be your primary concern. Uh And I also don't think that um doing an ACF interview, for example, would be part or going through the application process of an ACF is going to uh massively help you with your clinical applications because um a lot of the stuff at the as a interview, the format, the whole application as we will go through it later is a little bit disparate to the clinical one. I'm not saying there's no overlap, but I wouldn't necessarily expect uh that being prepared for an interview will solve again, the clinical application process and the clinical interview. Um So just be mindful of that, that there are a little bit separate processes, right? What doesn't, how do you apply? OK. So you have to go on or which I assume that everybody's familiar with you go to vacancies. So you essentially try to uh type in radiology and uh by, you know, until, well a little bit un until tomorrow at 4 p.m. you will get all the ACF post and radiology uh that uh are around the country. Um I would say the major difference with clinical applications which typically consist of a lot of tick boxing. So you have tick tick, it is very quick, easy to apply for clinical radiology. I think the ACF is a little bit more uh uh has a little bit more um uh difficulty in that you have a lot of free text fields to populate. OK. So that's something to be mindful. However, for anybody who's feeling brave for a deadline tomorrow, there are ways around that too and we can talk about them uh by giving a few tips. So what does it look like? Well, the initial sections are a little bit unremarkable in that they do have a lot of fields that you populate just like you would a clinical application. Uh The clinical radiolog application particularly has foregone any free text uh which is it II think it's, it's a little bit restricting and that you, you don't actually can actually have any nuisance in uh in terms of what your achievements are. But in the af there's a little bit more um uh opportunity to basically showcase your achievements compared to your clinical application. So you can list your undergraduate degrees one by one if you have any, any postgraduate qualifications. So for those of you that have done any college exams have got uh another postgraduate degree, have got some kind of teaching qualification. Anything you can actually list it with a date of award, you can put down your prize awards and distinctions and list them again. Um And also do the same for any training courses you've attended uh that showcase your commitment to the specialty and to the field that's a little bit different to the clinical radiology application where you literally score the highest of those qualifications and the people don't necessarily care about all the rest. So if you, for example, if you had, let's say, um if I remember correctly, one of the teaching uh and can actually, you know, correct me on this. But I think you have like a teaching qualification. Uh That's an an MSC in, in clinical radiology applications. You get the maximum points and people don't care afterwards what you've done that's under that. Uh But here you can actually list all your teaching qualifications, one by one. You can list any courses you've been in onto. So uh it's a little bit more comprehensive. It's a little bit more reflective of your achievements. Can I just interrupt that? I believe that won't be valid as of next year anymore? OK. OK. Uh That's good to know. Um Now the main sections. So those are all free text. OK. So the very first is a very short field that says achievements outside medicine. Here, you could put anything you want uh any sport activities, anything you've done that, you think it's worthwhile, any volunteering. Um All these things that uh we used to put in oral and special training applications back in the days as many years ago before the tick boxes came through. Um It's very short, it's about 200 words I think. So it's not particularly long. Um And you can list all your achievements there. The presentation section is divided in local, national and international. So there are literally uh three fields where you, you list your presentation sometimes in many applications, uh they ask you to actually state your role in the presentation as in, did you submit and present, did you analyze the data? So usually there's like um this free text we can actually say I presented, analyzed and uh uh conceive the project, let's say, or the presentation or the abstract publications are divided again, they have a lot of free text where you're, you're supposed to list them all in first and last uh or, or first or a call for position. You have to uh present them in a pub or some kind of other index format. So you can just like say, yeah, publish this. You have to put your, your, the actual presentation, your name on the, on the author list, the actual uh issue of the, of the journal that you publish the date and all of the. And if you can actually do OIS or any pub uh indexes that would help people track uh those publications teaching here. They usually, again, there's like two boxes where you put in your experience, your, your qualifications. So you can say things like uh I attended um I teach a trainer course and then down, down the, the next box, you can say I organize a teaching program for um medical students and I got feedback and, and so on and so forth. Uh The same for clinical audit. Uh There is a suitability commitment section, uh which is basically a little bit phrase like the in the boxes that I've caught before. So they have two separate sections. One suitability for specialty saying, describe what you believe you meet the person specification for the program you're applying for and include the particular skills and attributes that make you suitable for a career in the specialty. So here I think they're looking for uh things that are a little bit more generic about yourself that would make you suitable for a career in radiology. Um So usually there's many ways to answer that. But you can say, for example, things that you're analytically minded or you're detail oriented that you um you have basically got clinical experience that will help you um translate that we translated in a radiology training program that would be helpful for someone in, in that position and so on and so forth. And then the commitment to specialty uh this is a little bit bizarre because it says to provide evidence of activities and achievements which demonstrate your commitment to career and the specialty and so on. So I think a lot of the commitment to specialty uh tech free text will include a lot of the stuff you've done, like presentations, publications and all that. If they're radiology related, obviously, we can list them here but put them in a nicer uh framework and say, for example, uh I'm a good clinician. I'm a good teacher. I care about quality improvement. And I'm, I'm basically good in research and uh I'm committed because I've done uh radiology related things in those domains. And there is the last uh management and leadership um section which basically involves uh talking a little bit about things you've done along those lines. Overall. If you really look at, you know, take a step back from me, it's gonna look at the, the layout, it's essentially a clinical application, right? So, um like we said before, you, if you had the teaching, let's say qualification and a clinical application, you just take a box here. The only difference is that you just have to list them in a free text and put them in a little bit into context. Similarly for presentations and publications, that's something you would have done for clinical applications. Anyway. However, here you just call to actually give specifically the uh publication presentations and your role in them. So it's a little bit more free. And I think that can be both daunting, but it can also be a little bit liberating because like I said before, it gives you a little bit, it personalizes your application a little bit more. You can write anything you want, you can say what you've learned, you can say talk about a little bit of how a particular experience shaped your your views or what you learned by publishing a particular paper you learn as particularly cool data analysis technique where you can put it in there and say I learned this and this and this right after, right, right after your uh your publication. So it's both a curse but also an opportunity. Were you happy to take questions now or did you want to take them later? Yeah. Yeah. No, let's do it like that. Yeah. OK. So we've got two questions. The first ones from Patel asking what Q I projects count in clinical audit section. Sorry, what, what project would qi projects quality improvement projects count in the clinical audit section? Yes, I II would put them there because uh by audit, we, we generally say something, we'll put them on the framework of clinical, of quality improvement and I would put it there. Yeah. And the second uh if there is a publication or some kind of presentation that arose before because of the project, I would also put it on the publication and the presentation section. Well, thank you. And the second one is by Doctor Hanno. Um They're saying if I am already in in radiology training and applying for the ST three ACF post, how would I put together evidence of my commitment more than being a trainee? Uh It's a tough one. I think uh you still have to, the way I would approach it would be that because you're applying to an academic program. Uh I mean, it just to disclosure, I haven't done that. So I don't know what would work but the way I would approach it is basically say I'm in an academic in a training program. But I have demonstrated research potential and commitment to an academic uh radiology pathway by doing XYZ. Maybe it's uh uh some research project you've done or paper, you published a present, you me at a conference um basically taking steps to show that uh you have done everything you can to create a momentum for your research. But also I would also say what you've done so far to become a competent radiologist in those two years, for example. So if you so say that, you know, you pass for your exams on time or that you received feedback from your supervisor and superiors that is actually very positive or that you've uh pass all your assessments on your uh Kaiser portfolio successfully, all these things. So show commitment because it might be that you, you know, you got into radiology but then, you know, still struggling to pass part one after like 23 years. So that could be a bit of a problem. So uh that's, that's how I would approach it that you are committed to academic uh research, but also uh to becoming a safe and competent radiologist. Those are great examples. Thank you. We just have one last question on, on this section is very weak portfolio worth the trial. Sorry, I'm not sure what that means. If you, if you would like to um rewrite that question. Yeah, I think, I think I know what they mean but yeah, let's, let's wait for them to reply. Yeah. Ok, fine. Um What courses do you suggest listing? Would you recommend adding als courses, other clinical courses or do you suggest adding academic courses only? No, absolutely. No. I think you should. Uh I primarily focus on the clinic, do a mixture. So things that you've, you've done that are absolutely essential clinical courses uh that indicate a little bit of competency, put them down. If there's uh a research course that you've done that you're particularly proud about, put it down as well. I think there might be a limit of six courses. So I would do mix and match uh in all honesty. But you have to also remember and this is something I'm gonna go through in next slide is that you always have to remember. You are applying for a clinical post. You, you know, just, just doing the academic thing won't cut, won't cut it. You know, they need to see all these things, they need to see the presentation of publications, but they do need to see that you've done courses, they need to see that, you know, your previous post that you've downloaded, that you have done some management and leadership. So it's just imagine that it's uh basically a buffed up clinical application with more focus on research. But uh just putting academic courses. So if you've done, let's say if you only put down data analysis courses or something like that. Uh That's great. But uh you know, it would be a shame not to put a college exam or an ALS course you've done. I think so. I think it's just by finding a balance. Yeah. OK. Have we got the clarification for the previous question? And that's going to be the last question for the section if that's OK. Um we'll leave the questions to the end, I think next month. Ok. So the clarification is portfolio of one research and no audit. Would it be appoint? Hm. Uh I honestly don't know. The thing is uh I think because of the scoring system and how these, the process has become, which is basically lots and lots of applications. I think when I applied, there were 80 applicants for the Imperial acf uh I think it's just such a big number to scrutinize that. II don't think they're gonna look at it like that. They're gonna look at it. Ok. What's the point? What are the a total of everybody's points? So I think even if you don't have um one section and if you put in one section, I don't think you should be discouraged from applying because you don't know how all the other stuff is going to add up. You don't know who else is applying you. You just simply don't have enough information to say. All right, I don't have any other that I'm not gonna apply that. I don't think you should think like that because uh yeah, I'll, I'll explain a little bit more later. Um What I think about the process as well. So, but for now I'll leave it there. Um Then there is a um there is a research skills que question that's, that is, this is basically where um I think this is a lot of the meters in terms of the research, they will ask you a lot of detail as as to what project you've done. The first question is to give brief details of research projects or research experience you've had uh you know, including methods used and, and you can say things like I've done, for example, a data, a retrospective database analysis. I learned how to enter data into a spreadsheet. I've learned how to analyze and present uh data. Um if you've done a presentation and things like that and then list, list everything you've done. Um And then there's another question that they ask you to describe one of them in detail. So this is where you basically throw everything and really expound um on the research that you are particularly proud of, that you're most proud of and then say exactly what you, what you've done, I think here and this is ties a little bit to the last question. I know there are a lot of people out there who, you know, perhaps haven't published or perhaps a field. They haven't done a particularly good research project, but the reality is that you are um in a position that most junior doctors are and most, you know, daughters will not have the opportunity to do. The cutting edge research is going to be sparingly amazing on the obligation. That doesn't mean you can't write anything. What a lot of um people are looking for, a lot of employers are looking for are reasonable. Uh People who have potential and that could be, for example, how you phrase things on the application, you could say, yeah, II only did like an analysis of, you know, 30 patients on, on blood results. I don't know what it could be. However, I've learned XYZ um I've, I'm taking these further. Uh we, we publish it, you know, and we present a departmental meeting and be encouraged to write a paper on it. So always try to write something that shows how you've reflected on the project you've done and how, what you've learned from them and how your skills are actually transferrable. It can be taken forward because it's all about potential. Like I said, at the very start of the lecture, they're looking for people with potential, not actual achieved researchers, really. That's the principle of it. Then there is a, a question about why you want this particular academic Clinical Fellowship. So here they want to know, OK, what are you gonna do with this? We're gonna give you this post. Um And here, essentially, you have to say that I'm gonna generate data um aim for a higher degree and become a clinic academic with interest in. So, and so, depending on what your interest is, so they want to see people who will take this ACF and, and essentially take it forward and create a research program or really start thinking about a career in academic radiology and say uh this is how I wanna contribute to the, to the space. Uh What I think I wanna do later on is how do you see yourself in five or 10 years, kind of thing? OK. So it's a lot. Uh And I'm sorry if you're feeling a little bit overwhelmed. It, it sounds like it's a lot of free text, but the way I approached it and it's kind of worked and I think it works very well is my, my thinking process was the following I thought, OK, there's gonna be tens of people applying for this. You have to be clear and concise. You, you can't spend too much time basically, uh writing paragraphs and paragraphs about a particular approach. You've done very short but very written information, small paragraphs, 23 lines per paragraph. Say, for example, if you write about an audit, say I've done an audit in this topic on auditing patient notes in this department, I conceived um and implemented the audit. I found this and this and this uh I presented my findings at the departmental meeting and I learned how to analyze data and took the project further in in this way, that's it. Stop next paragraph. So very short concise paragraphs. I also I use a lot of lists. So in the teaching section, for example, I presented all my teaching achievements in the list format. I put um not dots but let's say dashes before each uh uh achievements say for example, uh sys for medical students in, in, in Oxford or um uh anatomy sessions for UCL, second year UCL students. And then I wrote a little bit about what I did in, in each one of them. I said that I got feedback on what I've learned, but it was literally like that. It was teaching achievements, 1234 and then underneath teaching qualifications again, 1234, did this course uh that course and so on and so forth. That's an example. Uh publications is very easy to create a list because you can just copy, paste them or presentations on uh from PUBMED or somewhere else. Uh There is a danger here also to contour up or oversell any achievements do not do that. You, if you get found out that's a massive problem. You uh God knows what might happen. Be honest, be proud of what you've done no matter how small uh be forthright and always demonstrate that you've learned something from everything, single things that you've done and how you can actually take that skill that you've learned and apply it in the future. So if you say, for example, analyzed uh data for a research project or a particular presentation or an audit, just don't just say analyze like data, say analyze the data. I learned how to do this in Excel or R uh I produce plots. This is something that I believe is a good foundation for a future clinical academic to basically be able to analyze data. OK? Um If you get to the interview stage, what happens is that you get a separate interview from a clinical one, usually either right before or right after Christmas, which is a little bit annoying because it can sometimes ruin your holiday. Uh That's online, the leads, uh the people who are attending the interview are usually the leads of the academic uh clinical fellowship program. There could be other academics there, there is usually often other than another clinician. Sometimes it it could be the training program director and there's always a lay representative. So there's four or five faces you'll see on your screen on the day. And basically the good thing about these interviews is that is that the questions are very streamlined. So you can actually find them on the N hr website. There's no like hiding from the questions, they're the same for each candidate. Uh There's no like variation they ask the same questions. Obviously, this year, I think I checked and they're going to be probably the same next year when this year for, for next year's recruitment. And the, the interview itself is dividing two main sections. The first one is a data analysis and publication question which nobody can predict because we don't know what they're gonna give you. And the remaining interview is basically revolving around your research achievements, which you've already kind of written a few things in the application form and then awareness of the programs and the demands of balancing the clinical and academic um component in your training. That's it. OK. Um And there are questions that you can definitely prepare for and you can definitely rehearse and have them ready and there's no excuse for not basically giving them. And there's questions that we simply can't do anything about you. They're just out in the air and there's, there's the element of unpredictability in them. The main one is being the the date of preparation. So what they do in the data, a preparation question is they give you some obstruct or some, usually it's an obstruct or some plot or graph from a study, they give you five minutes to sit down and uh um essentially take some notes. Um Actually, I might be wrong. Actually, it might be 10 minutes anyway, whatever it is, the time flies very, very quickly you won't believe. And if it's 10 minutes how quickly the time flies as I, when I was doing it. I felt I was literally warped into this alternate dimension where time flies like 10 times faster, you read it and you literally have to take notes. You have to be on it because what you were supposed to do is explain in very few sentences. What did they have shown, um actually do a critical appraisal on the spot. And then also you have to prepare a small section where you present the data to a lay audience. Um Like I said, the interview is very quick, the time flies very quick, they've got lots of questions. So don't imagine that this is like some kind of long process, we can talk on and on and on. You have to be very, very structured, how you present the data. Um uh And essentially what you're looking for is do ap O format which a lot of you might be familiar with, say, what's the population? What's intervention? What's the comparator and what's the outcome of the study then give a um a general appraisal of the methodology? Is this correct methodology to answer that particular question? Is there any source of bias? What are the statistics that were used? And where the appropriate for the research question that was asked if you have, if you have this kind of like mental map in your head, you're probably gonna be OK because then you have to basically uh say in no more than four or five sentences to the, to the panel. This is a study of X. Uh The study used this particular methodology to answer a particular research question. I think um uh there were sources of bias that uh for example, it was selection bias in a study, but the authors addressed it in this particular manner and they used the T test to uh to validate their conclusions. Um It could be something simple as that and then you can move on to actually say what you think about the study. You can say, I think the study is a brilliantly performed. However, there were some uh sources of uh bias that I think that they should be addressed in future publications or future, future research. Or you could say that there were a little bit too generous with your conclusions or too uh restrictive. Uh, all these things you can actually say, uh, what I would also caution anybody here is to not, um, ever trash a paper or whatever they give. You never say it's rubbish. It's, it's a crap. Even if it is, you have to find something positive to say, give a balance, you show that you're a nuance person, you actually appreciate the benefits and the downsides in every situation or every study that your, your, you're basically reading. So don't be dismissive or, or rude. Just give an honest opinion and try to find something positive much like the bullet point list and concise format of the application. I would advise anybody to be the same at the interview. Don't blabber on and on and on to say, feel for good concise sentences are better than going into the spiral of actually talking endlessly and then getting people lost in the process that's very difficult to achieve. I know I've been there, I've been terrible at interviews in the past. Uh But if you find yourself in a good headspace, I think it's totally doable and it's the best thing you can do it during the interview. Then what follows through the interview is a list of questions that are very reminiscent of the research aspect of the application. So they tell, they ask you summarize your academic achievements, your contribution. So you can say here to talk about your uh project or things that you've done in the past um and describe your personal practical experience of research. Um They will ask you things like what research within this acf interest you uh here you have to uh show that you've actually looked at the job description that you know what the research is about and have a rough idea uh what you wanna do and why um they will ask you to share an aspect of uh research that you read recently that is outside your area of interest. So before the interview, you're gonna have to basically, you know, a week or two before uh scrutinize, I don't know, New England Journal of Medicine. Come up with some clinical trial and maybe just go through the abstract and really, really, really go through it very well and know it so you can give a ready uh response to that question and say uh II, for example, if I remember correctly, I think I talked about a phase two trial on psychedelics and MRI. Uh so they uh yeah, psychedelics about depression. Uh It was a trial back in a new little journal of medicine. I think that's if I remember correctly, that's the study II kind of prepared. And then they ask you what are the challenges to balancing clinical academic roles? And here you have to basically show awareness of all the issues that I've told you that you have to, you have to know the structure of the program, know you have to achieve the competencies of both domains and again, give a balance. You say, I know that the uh clinical program is gonna be very demanding and the academic um and clinical site might sometimes clash and you have to be to, to say that you're going to uh plan in advance, be in constant communication with your supervisors on the clinical and academic side. Um And you know, basically show that you are not going to compromise your clinical development to complete the research project to write a paper that you're gonna be a safe radiologist. Um And you know, be aware of the clinical commitments, like passing your exam in the first year and so on. And this is where you kind of have to say that you're aware of all these issues. Um Now if you uh sorry, I'm gonna go back one because this one is in light blue that I think that are literally on the plate. They're the, they're there for you to basically uh get because those are questions you can prepare beforehand. You don't need to think uh you can get full marks for those questions without necessarily um any of the other questions affecting the marks you get in those three. So your academic achievements are what they are at the point of application. You can't necessarily write a paper in a day or two or a week or two or a month or two even. So you can't do anything about that. But what you can do is basically prepare all these questions on this page as much as you can to get maximum points. And again, uh much like in the application, you have to personalize your responses. If somebody asks you, for example, what are the attributes of a, a clinical academic cardiologist that are beneficial? You don't just say, well, the attributes are ABC, you say the attributes are ABC. But I've got a, I've got B and I've got C because I've done XYZ, right? So it's always about you, you'll bring it back to your achievements and it's your interview. Um It's your, and that goes, goes through the application, of course, it is your application. So basically, just talk about what you have done and what you are proud of. And as, as we discussed briefly in the application section, again, in the interview, you cannot compromise um clinical safety and competency. Sometimes in uh II have had uh a situation where in previous ACF S uh because I interviewed a couple of years in a row actually for an ACF uh they asked me clinical questions. So they told me if you embolize the wrong limb, what do you do? This was from a TPD. So that was in the middle of an ACF and I was completely thrown back because I was like, what the hell this is like departing a little bit from the format. But they could ask you stuff like that and you have to obviously answer the scenario but say uh things that essentially really say that explicitly and say, I, my first and foremost target is to become a safe and competent consultant, radiologist. That will be, that's my primary aim. And I wanna become a clinical academic, but nothing should really overtake uh the um uh the safety of my patients is non negotiable. So something like that. So that has to be something you really have to stress to your, your interview and your application if you can. Um after all this plaa suppose you don't get it. OK. Uh which happens has happened to me, uh there's some things it could mean and some things it doesn't mean not getting one what it could mean. It could mean that you need, just need additional research experience. Maybe there were people there who had done shit tons of research and you just simply couldn't compete with. That's ok because everything, uh although you didn't get it this year, you can actually rectify that by doing more research for next year. Or it could be that for some reason, your interview skills weren't as published on the day because I don't know, you were stressed or, you know, uh there was some aspect of um uh you know, um a particular interview question that you're not feeling comfortable with and you just didn't get it. And this is where we have to be a little bit um realistic and real. There's always an element of luck. People don't like saying this. Um I've been through enough in the recruitment process and the NH just to know for sure that anybody that tells you to go to training post purely on their merit is just rubbish. Like there is always an element of luck. There was certainly an element of luck in my case. I'm not saying I wasn't worthy of it or that didn't do the work. But um I cannot for a moment believe that out of those 80 applicants that are on there, there are some stellar people that didn't get it. It's simply not true. I'm pretty sure there's wonderful clinical, uh, doctors out there who done shit, tons of research deserve to get it as much as I did. Uh, and they just simply weren't like the other day for whatever reason. I don't know what the reason could be. Um, so always be mindful that there is an element of luck even at your, at your best, which is also a reason why you should apply even though you think you're not, might not be worth it because the process can be a little bit random and you might actually get it even though you believe you haven't done so much, that might be your perception, but it might be the one you actually get to the process. That's absolutely fine. What you've done already is more than enough. And what I would do is basically focus on clinical interviews 100%. Uh like I said in this lecture at the beginning, the clinical interviews are the most important thing, right? So um uh ii cannot stress that enough. It doesn't mean if you don't get an a uh an acf that you like what it takes to become a clinic academic and also going back to the clinical interviews, it does not mean you will not have opportunities for research again, simply because um and to be entirely honest with you, um once you get a number, even from a clinical pathway, there are so many ways you can actually satisfy your appetite for research. Uh Especially now it's even possible to reduce your clinical time and go less than full time without giving any reason whatsoever. It used to be the case that, to do that you could actually, you should, you should actually have given some proof that you, um, um, you had some caring responsibilities or that you are, um, you know, uh, I don't know, whatever or you have a sick family member or something like that, but nowadays, you don't even have to do that. You just say I want to reduce it to 80%. And if it's feasible within your training program, they will do it. So you might actually get time out, that's enough to keep you sustain, to sustain a research program. So there are so many ways to do it and I sometimes wonder where the future of A CFS lies in the, in the, you know, domain of, in the current, the existing like NHS an academic domain. Uh I'm not sure. Uh we're not gonna find tonight, find out tonight, but II can tell you for sure that not getting an ACF is really, really, really no biggie. II can't stress that enough, particularly if you have a clinical um number. Um I'm gonna leave it there. Uh But I know you must have a lot of questions. So I'm just gonna ask as many as I can in the time we've left. So, yeah, thank you. So we have one question. Um Does your portfolio count in final selection or is it 100% interview based? Uh That's a good question. Honestly, I don't know. And one of the reasons I don't know is they keep changing it every blood a year. Like I don't know when I last year, I think they had increase the portfolio from the year before, but I really, the percentages are constantly changing constantly. Uh I should also stress that the, the M SRA is like contribution is also changing constantly. Um I think with ACF S in at one level in radiology uh and please don't quote me on this because I might be wrong. But I think it's generally considered a somewhat separate process from the uh clinical one. So they do focus a lot on the person rather than the score. Uh But you still have to pass your M SRA that's kind of like non negotiable. So uh you, if you were to be successful on ACF and the clinical one, you actually get to job offers and you have to reject one of the two, that's how it works. So, um yeah, I don't, I don't know exactly the percentage contribution for this year. I'm afraid for the interview versus portfolio. Yeah, sorry. I I'm, I'm I'm not prepared for that question. Yeah, no worries. Um Then the question after that was uh can you go less than full time on an ACF E technically, you can, uh because um you can do that. Um However, you're gonna have to consider two things. One would be the impact on your length of training because it might actually prolong your training for quite a bit because um and then the second is that you have to consider the implications of your clinical training program because it will be very difficult to make a case, I think with the TPD uh and the clinical department that you're working under to um reduce things even further, it's doable, but it will take a lot of discussions and negotiating and it will depend a lot on the department you're working under. I would assume because obviously, if you have a really over stress department, they expect people to do on call of to and beyond. It might be a little bit tricky to say. Yeah. Well, I've got 25% of time and I will drop it even further to, um, I don't know 60%. So that could be a little bit difficult. But in theory, like purely on paper, it's not forbidden, let's say, but I think it will be very difficult in practice to do that. Yeah, I probably would echo that. Um, even outside of radiology, when you go less than full time, as he said previously, you still need to meet all your clinical requirements. But in less time than doing that and it will be the clinical side that you'll be taking time out of. Um So just think of it as you're trying to fit five days worth of work in or training in, in three days. So you need to be very organized. But yeah, it's not impossible but it is difficult. Um All right, the question after that is, do you know of any acf interview prep courses that you know of? Uh I think a lot of radiology prep courses, uh interview prep courses are out there. Uh I think I'm personally aware of. Um I don't know if you know the guys that do broadcast, for example, they do uh personalized interviews that could be helpful for an ACF process. Um But I think the general principles that I told you tonight are ba basically basically apply I um concision uh clarity and then personalized responses are the three things you have to be aware of uh short snappy personalized. That's the key thing when it comes to the generic questions. Uh And then in terms of the data analysis, it's just a, this is basically a little bit difficult to talk about because it does depend partly on your critical appraisal abilities. Uh I was lucky enough to come out of busy process where my, I was very on it. Um I'm not saying you need a phd obviously to do a very good clinical appraisal. You definitely don't, but it, it was something that didn't particularly face me, but I cannot appreciate how it could be a little bit daunting to be just be throwing an abs in your face and expecting 10 minutes to generate all this kind of like answers to these questions. But yeah, uh, I would look out there for, yeah, RACA is one of them but there's many, many other people who do interview prep in radiology and if you contact them on a 11 basis and say I've got an, a safe interview. Can you specifically tailor a session for me? Uh, one evenings or and do some, some uh interview prep? I think they would accommodate you. Great. Thank you so much. Um I think you covered this briefly earlier on. But um, the question asks, what about getting the ACF post but not having a training number? No, the sf comes with a training number. II was saying sorry if you don't get the, the, the, the clinical, I assume. Yes, I think, I think that's what they, they're asking. Yeah. No, they're, they're, they're completely separate processes like I said, uh yeah, II did cover it. So, uh you, you did say that. So, so basically you, you get a completely separate offer from for an ACF and a completely separate offer for clinical that happened in my case and I rejected the clinical. That's what happened. I could have rejected the S EF but that would defeat the whole purpose of world blind. So, um, but for both, you have to pass your M Sra for sure. There's no doubt. And you, what happens at one? It is a little bit bizarre because if you did, let's say NST three level, um, uh, application you, you, I mean, I guess I could the same for one as well, but essentially you have to deem the point to get an ACF. So that's why again, going back to basics, if you didn't pass your M SRA or you said something profoundly silly and you're a safe interview like, yeah, I don't care about the clinical like let them die. I'm gonna do my research. You will not be appoint, you would simply wouldn't pass even if you had stellar research achievements. So you have to be safe and appoint as a doctor before you get offered an ACF and if you do get an offer, the N ACF, it's a completely separate offer. Yeah. Yeah, that makes sense. Um Question of that. Is it OK to repeat yourself a few times in some of the er W SQS Ws Qs meaning the questions of I think. So let me see. Yeah, I, so yeah, so I II presume if you mean if they mean whoever is posing the question, if they mean the application. Yes, I think so because in the portfolio section for clinical radiology, you can put the same thing but in multiple sections. Absolutely. Absolutely. So I imagine it. Yeah. OK. Yeah, absolutely. So I, so if uh the very first section where we said you put on your training courses. If one of those courses is on teaching, then they will ask you about it in the teaching section, um and so on and so forth. So don't be afraid to, to say, um, even in the presentations, for example, um, my very la if I remember correctly, the very last paragraph where I was finished off my response. I said, for example, I've, I've presented in a lot of regional and departmental meetings. I didn't put down all the, all the presentations I did, but I uh put in parenthesis irrelevant section and then prompted them to look at the audit section for all the presentations. I've done audit related that are not, let's say in conferences and stuff. So there's lots of uh yeah, there's a repetition but don't, don't worry about that. Just, just put everything think laterally if one achievement covers many areas, but in all areas, great. Um Do we know how the ACF portfolio is marked and the appoint score? Uh I don't, but I think if you go on the N hr website, give a little bit of detail, you can actually find the score sheets for the interview itself. Uh The application is a little bit more nefarious, has a score because obviously there's free text involved and it's kind of difficult to, yeah, I don't know if has any information on the website on that, but I honestly don't know. I would assume that there's some kind of minimal score that people are expected to pass. Uh They like a few applications, then you invite them to interview. They're not, you, you have the standard NIH R template which is a score from 1 to 5 and people literally just going through the sheets. Um Yeah. OK. Um How to sell the experience as clinical research fellow for an A for the ACF POST? Sorry, could you repeat that again? So if someone's done an ACF post, um how would you um sell that experience? How would you describe it in both the the form and the interview? I assume uh you mean the uh a safe in another specialty or a clinical fellow in um clinical research fellow? So if you did a clinical research fellow, sorry. Yeah. So absolutely. And you, you really have to, I mean that would put you in a unique position. II think because if you're a clinical research fellow, you've done uh you have a few achievements in research under your belt, then you can obviously populate a very obvious one. So populate your presentation and publication sections or whatever, but also you can um talk about projects you worked on. If, if you remember in the uh application, the application, there was a section where you have to describe one of your, your projects in detail and say what you've done exactly. Um It could be, for example, if you were a clinical research fellow doing recruitment, trial, recruitment for patients. But you can say that and, and then really lay down exactly what you've learned. So principles of consent of good research practice. Um How do you ask ethics for a trial? Um How do you analyze data? Uh what's equipoise all the terms you use in clinical trials, all the things you've learned equally. If you're a wet lab, say I've learned unit chemistry, I've learned this or that uh data analysis equally. Say, I learn some basic programming skills and say, and, and then literally sell it and say these are transferrable skills that are the foundation for a clinical academic career because they will help me transfer them from my previous post to this one. Then bring my expertise and my um experience and research with me, critical thinking, analytical thinking, writing, all these things have to be sold. And I think some of us we we, we forget as doctors to really but ourselves a little bit on the back about all these things and really say them out loud because you know, nobody can, there aren't that there aren't that many people that can pick up a a laptop and write a paragraph really quickly. That makes sense. That's a skill you develop, right? So um yeah, if you have a uh a fellow post, think about all the things you've learned that you're gonna bring it to the table for the for the employer that that's a, that's a good thing. Yeah, I think like mail says, break it down, make it really simple, bring it down to the basics and um yeah, and you'll be able to sell those. All right, a couple more questions. Um Can you describe the acf role in a bit more detail and how is it manageable with the clinical part? Um This person has heard of people taking time out of training to get the target of the um the clinical tasks. Yeah. Uh So I'm still learning uh in all honesty, like I told you the, the, as I say at the beginning of the lecture, uh you have to decide firstly, what the four months is gonna be. Is it gonna be one day a week, one month every four months or like a whole block? Uh I have my own opinions of the topic but different people have different approaches. Um And what I did really early on is basically meeting with my academic supervisor very, very early even before I started. And I said, OK, what are you guys doing? What do you want me to do? That was basically the essence of the meeting. And I, I essentially, we had a discussion where I requested essentially clarity as to you can give me something that I could work towards, uh let's say in the, in the first assistance. And I basically managed to derive a list of simple tasks like selecting patients for a study that are not too demanding and nobody's at this stage is asking me to write a paper on, on the get go. Right. So I'm doing something that's sticking along um with a few more things in mind towards developing a paper maybe next year. So I'm not immediately jumping in the research stuff. I've got lots of stuff to learn on clinical. I don't wanna fall behind on that. I don't, I really have to pass my exam. Um And to be honest, those situations, you have to be firstly a little bit aware of the research people are doing. It's very easy to get sucked into some kind of like lab based project, for example, that goes on and on and on. And people say to you, yeah, you generate preliminary data. Uh but then you do experiments in the lab, they fail, they don't work like you spend a lot of time learning a particular technique, you i it it's a very difficult tension to get right and it's part of your learning. So you, you, you're gonna have to be called to make decisions at various points where you say look, this is too much uh it's compromised in my clinical training. I don't want to fall behind on that. Um And actually walking up to an academic supervisor and saying that is actually quite scary. I likely haven't had to do that. But ultimately, that's part of the process is also like saying, OK, this is what I can do and this is what I can't do in the liver and be a little bit, uh, proactive in that and don't over promise people in the academic side, uh, because really nine months overall broken apart is you can do a few things, but you can't really, you know, invent the wheel here. Like you, you can, you can produce some preliminary data, like I said, maybe write a paper or two. But I don't think you can do more than that in all honesty. So you have to be constantly aware that your clinical is the utmost kind of focus and uh and the nature of the research you're engaging with plays a huge part of. So you're gonna manage it. So if I had, let's say a lab based project doing one day a week, I think it's ii it just wouldn't work some experiments in the lab. Take, you know, a whole week, the whole experiment takes a week. How are you gonna do them? You can't um if it's a clinical trial or a data analysis based project, maybe one day a week is a little bit more feasible. Um But those are the kind of things that you have to contend with. It depends really on a case to case basis. My, my research at the moment is purely dry computational data analysis or data collection exercises. So uh but I find that I can't do the whole one day a week thing because I II need to get in the certain headspace to start thinking about research before I actually produce some ideas that are useful. So I was thinking about getting a blog uh and also gave me, give me a little bit of opportunity to um y you know, if there's some dire need to engage a little bit with clinical, it won't be the end of the world if I um you know, the old day here and there, I did something clinical but uh i it's very difficult balance to get right. And this is basically why you need to also have that question in the interview. Quite polished to say that you are aware of those tensions and you're going to resolve on true communication, uh, proactive management and so on and so forth. Um Yeah. No, that's, that's really sensible. A couple more questions on the M SRA. Um is the M SRA um is the A CFM SRA cut off the same as the clinical cut off? So it is estimated that the clinic cut off will be about 5 65 65 this year. So it is the same. Yeah. Yeah. Yeah. And um someone else on the M SRA, do I need to reset the M SRA if I'm already a radiology trainee, I'm not sure what the situation is, but sounds like they're either applying for ST three A CF or maybe that is, I wouldn't be I think so. I don't think so. I don't think you should hear you. I'm sorry for that. No. OK, great. My impression is that you just transition to the role if you already hold the number. OK. Any advice on targeting the um W SQ. So I did a quick Google um work skill qualification in A I as a lot of the ACF S are in the NH NIH R digital theme for this year. Oh White space question. Sorry, sorry. So, so the free text question on A I um as a lot of the A CS are in on the di digital theme this year. Mm I assume the question, whoever's asking the question means how you can um answer, answer about an A I related theme or using A I to respond. I don't know. So I think it's, the question is in A I um because the ACF S are on the digital them. So how, how is A I gonna or um how is A I going to change medicine or how can you know, how have you had any experience with A I or I mean, here it's, it. Yeah, I mean, I this is a little bit of a matter of opinion like that's basically um I would approach like questions like that again with a nuanced response. Um So again, part of being a little bit of a, a clinical research is basically giving nuanced opinions on things because you can find uh multiple language from a topic. So there are people who say, oh, it's gonna take over everything. It's obviously an extreme opinion you can say um that, I mean, a again that I'm, I'm just thinking on the spot here, I don't have a prepared answer for that question, but I would say something along the lines of that. It's definitely going to um impact the way diagnostic radiologist, diagnostic radiologists are doing their work. You might facilitate the reading of images, you might reduce uh waiting time or costs for services. But at the same time, it creates legal and ethical issues. I mean, if the A I does makes mistakes, what do you do? Who's legally liable for that? Um Also um intervention might be also A I assisted, but obviously you're gonna have to um still have to have the manual dexterity and the training to do the procedures yourself as a radiologist. So, um all in all I would say it's an opportunity and it will change the field, it will make it worse or better as people are, are claiming, but it will definitely change things and we have to adapt by, you know, doing A I research or particular A I modules or some A I training and radiology research. Uh That's how I would respond a little bit if it's a generic question, if it's like uh more specific, I mean, I would have to take it on, I guess the case by case by case basis. Unfortunately. I don't know. Um, yeah, I don't, I don't think either of us really know what that question is, is looking for, unfortunately. Um, but yeah, I think do what Bacillus is saying and just give a balanced opinion and essentially show how, you know, show that you can argue both sides and can see the benefits and the disadvantages of A I in healthcare. Um, I hope, I hope that answers the question anyway, I think that's all everything we've got time for today. Thank you so much for, for your time. It was so helpful to listen to you and I really hope that at least some people will do a last minute application if not me um for a CF tonight, um please all remember to give feedback. It will be really helpful for me and for Bacillus uh in terms of future planning for um talks. Um And thank you all for attending. I hope you all have a lovely evening and goodbye. Bye-bye.